Using pain-related brain activity to improve pain relief in infants

Using pain-related brain activity to improve pain relief in infants

Researchers have developed a non-invasive means to measure pain-related brain activity, which could help to reduce pain in babies undergoing medical procedures.

One of the major challenges to assessing and managing pain in very young children is that they are unable to articulate their feelings. Instead, paediatricians rely on observations of facial expressions or heart rates to infer whether babies are experiencing pain.

What’s more, administering pain relief can be problematic in small children because analgesics that are effective for adults might not be suitable for infants, who metabolise drugs differently – making the correct dosage difficult to calculate.

In order to determine a better metric of pain, Caroline Hartley, Rebeccah Slater and colleagues from the University of Oxford and Great Ormond Street Hospital established a measurement of pain-related brain activity based on electroencephalographic (EEG) recordings.

The researchers derived the EEG signature in a study of 18 infants undergoing a routine and clinically-necessary heel-lance procedure for newborn blood screening, then went on to validate their results in four additional studies of 72 babies in total.

The EEG signature was validated for use in babies born preterm, correlated with traditional methods (i.e. facial grimacing) used to infer infant pain, and was distinct from brain activity changes associated with non-painful stimuli like a flash of light, a gentle touch, or an auditory tone.

The measure was reduced when local anaesthetic was placed on the babies' skin, confirming that the measure can be used to test pain relieving drugs in infants.

The full paper, 'Nociceptive brain activity as a measure of analgesic efficacy in infants,' can be read in the journal Science Translational Medicine.